Chemotherapy of reticuloendotheliosis:Comparison of methotrexate plus prednisone vs. vincristine plus prednisone

Abstract

Twenty-eight children, ages 2 months to 13 years, with a diagnosis of reticuloendotheliosis were treated on a random basis with either vincristine (VCR) 2 mg/m2/week or methotrexate (MTX) 30 mg/m2 twice a week. Both groups received prednisone 40 mg/m2/day. The responders received randomly either MTX 30 mg/m2 twice weekly or no maintenance therapy. Of the 11 patients receiving VCR, 2 achieved complete and 5 partial remissions. Among 17 treated with MTX there were 8 complete and 1 partial remissions. The complete plus partial remission rate is 64% for VCR and 53% for MTX. The duration of response was superior in the MTX-treated group, with a median remission duration of 315 days; the 4 patients above the median are still in remission. With VCR therapy, the median was 96 days, and all patients have relapsed. Maintenance therapy also improved the duration of remission, with a median of 20 months, compared to 79 days with no maintenance. Thus, in this clinical trial the best results were obtained when methotrexate plus prednisone were used for induction, followed by methotrexate maintenance therapy.